Role of health check-ups combined with pharmacological intervention in primary prevention of chronic diseases: A review based on stratified management of blood pressure and blood lipids

Chronic diseases, particularly cardiovascular diseases (CVDs), represent the leading cause of mortality worldwide. This burden is disproportionately borne by low- and middle-income countries (LMICs), where health systems often face the dual challenge of communicable diseases and a rapidly rising incidence of chronic diseases. Consequently, strategies developed in high-resource settings may require significant adaptation to be feasible and effective in these contexts. Health check-ups serve as a critical entry point for early risk factor detection; however, the conventional model often prioritizes identification over subsequent management. Concurrently, indiscriminate pharmaceutical prevention strategies risk overtreatment and poor cost-effectiveness. This review systematically examines an integrated strategy that stratifies individuals based on data from health check-ups via established risk prediction models, enabling targeted pharmacological interventions for those at moderate to high risk. It elaborates on the theoretical foundations and supporting evidence for the three core components of the strategy, namely risk identification, risk stratification, and stratified intervention, and analyzes the application of antihypertensive agents, statins, and aspirin across different risk strata, as well as discusses practical challenges alongside future directions informed by precision medicine. In conclusion, systematically combining health check-ups with pharmacological interventions guided by risk stratification, represents a necessary evolution towards more efficient and precise primary prevention of chronic diseases.